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Job Requirements of Provider contracting representative:
Key Responsibilities:
- Delivers professional activities in the Provider Data job family.
- Responsible for accurate, timely quality assurance for accurate reimbursement based on provider contract and area fee schedules.
- Provides quality assurance error reporting to data entry specialists and supervisor.
- Interprets update requests and coordinates with internal and external customer to clarify and complete.
- Applies standard techniques and procedures to routine instructions that require professional knowledge in specialist areas.
- Provides standard professional advice and creates initial reports/analyses for review.
- May provide guidance, coaching, and direction to more junior members of the team in Provider Data.
Key Requirements and Technology Experience:
- Key Skills: Provider Data Experience .
- Previous Quality Assurance experience .
- Plexis Claims Management Platform experience a plus.
- Strong knowledge in flat fee, RBRVS, "percentage of" fee schedule reimbursement types, medical terminology, ICD-10 and CPT and HCFA coding.
- High School diploma; at least 5 or more years of working knowledge with strong knowledge in flat fee, RBRVS, "percentage of" fee schedule reimbursement types, medical terminology, ICD-10 and CPT and HCFA coding.
- Strong organizational skills.
- Provider Data Experience.
- Previous Quality Assurance experience.
- Microsoft Office Products.
- Smartsheet .
- Plexis Claims Management Platform experience a plus.
Our client is a leading Healthcare and insurance Industry, and we are currently interviewing to fill this and other similar contract positions. If you are interested in this position, please apply online for immediate consideration.
Pyramid Consulting, Inc. provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, colour, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.
By applying to our jobs you agree to receive calls, AI-generated calls, text messages, or emails from Pyramid Consulting, Inc. and its affiliates, and contracted partners. Frequency varies for text messages. Message and data rates may apply. Carriers are not liable for delayed or undelivered messages. You can reply STOP to cancel and HELP for help. You can access our privacy policy
Do you meet the requirements for this job?
Provider contracting representative
Immediate need for a talented Provider contracting representative . This is a 06+months contract opportunity with long-term potential and is located in U.S(Remote). Please review the job description below and contact me ASAP if you are interested.
Job ID:25-69255
Pay Range: $27 - $28.78/hour. Employee benefits include, but are not limited to, health insurance (medical, dental, vision), 401(k) plan, and paid sick leave (depending on work location).
Job Requirements:
Key Responsibilities:
- Delivers professional activities in the Provider Data job family.
- Responsible for accurate, timely quality assurance for accurate reimbursement based on provider contract and area fee schedules.
- Provides quality assurance error reporting to data entry specialists and supervisor.
- Interprets update requests and coordinates with internal and external customer to clarify and complete.
- Applies standard techniques and procedures to routine instructions that require professional knowledge in specialist areas.
- Provides standard professional advice and creates initial reports/analyses for review.
- May provide guidance, coaching, and direction to more junior members of the team in Provider Data.
Key Requirements and Technology Experience:
- Key Skills: Provider Data Experience .
- Previous Quality Assurance experience .
- Plexis Claims Management Platform experience a plus.
- Strong knowledge in flat fee, RBRVS, "percentage of" fee schedule reimbursement types, medical terminology, ICD-10 and CPT and HCFA coding.
- High School diploma; at least 5 or more years of working knowledge with strong knowledge in flat fee, RBRVS, "percentage of" fee schedule reimbursement types, medical terminology, ICD-10 and CPT and HCFA coding.
- Strong organizational skills.
- Provider Data Experience.
- Previous Quality Assurance experience.
- Microsoft Office Products.
- Smartsheet .
- Plexis Claims Management Platform experience a plus.
Our client is a leading Healthcare and insurance Industry, and we are currently interviewing to fill this and other similar contract positions. If you are interested in this position, please apply online for immediate consideration.
Pyramid Consulting, Inc. provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, colour, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.
By applying to our jobs you agree to receive calls, AI-generated calls, text messages, or emails from Pyramid Consulting, Inc. and its affiliates, and contracted partners. Frequency varies for text messages. Message and data rates may apply. Carriers are not liable for delayed or undelivered messages. You can reply STOP to cancel and HELP for help. You can access our privacy policy